Pancreatic cancer

About 3080 Australians are diagnosed with pancreatic cancer each year. More than 80% are over the age of 60.

Pancreatic cancer was estimated to be the tenth most common cancer in males and ninth most common in females in Australia during 2017.

Two main types of tumours occur in the pancreas:

Exocrine tumours – These make up more than 95% of pancreatic tumours. The most common type, called an adenocarcinoma, begins in the lining of the pancreatic duct. Less common types include adenosquamous carcinomas and undifferentiated carcinomas. The name of the cancer is taken from the type of cells involved. This information is about exocrine tumours of the pancreas, usually just called pancreatic cancer.

Pancreatic neuroendocrine tumours (NETs) – About 5% of pancreatic tumours are pancreatic NETs. These begin in the endocrine cells, which produce hormones to control blood sugar levels. Learn more about pancreatic NETs.

Research has shown that people with certain risk factors are more likely than others to develop pancreatic cancer.

Risk factors include:

• smoking (cigarette smokers are about twice as likely to develop pancreatic cancer)
• ageing
• type 2 diabetes
• obesity
• pancreatitis (long-term inflammation of the pancreas)
• certain types of cysts in the pancreatic duct known as intraductal papillary mucinous neoplasms (IPMNs) – these should be assessed by an appropriate specialist
• drinking too much alcohol
• family history and inherited conditions (see below).

Most people with pancreatic cancer do not have a family history of the disease. However, about one in 10 people who develops pancreatic cancer has a faulty gene that can run in families. You may have an inherited family risk if you have two or more first-degree relatives affected by pancreatic cancer, or a history of an inherited syndrome. The “degree of relationship” describes how many genes are shared between two blood relatives. First-degree relatives, for example, your parents, siblings or children, share about half their genes with you.

Some inherited syndromes that may increase the risk of pancreatic cancer include:

• Peutz-Jeghers syndrome
• the familial breast cancer genes (BRCA1 and BRCA2)
• familial atypical multiple mole melanoma (FAMMM) syndrome
• Lynch syndrome
• hereditary pancreatitis.

If you are concerned about your family history or want to know more about genetic testing, talk to your doctor or call Cancer Council 13 11 20.

The pancreas is part of both the digestive system and the endocrine (hormone-producing) system. It is a long, flat gland about 13–15 cm long that lies between your stomach and spine.

The pancreas is divided into three parts:

• a large rounded section, called the head of the pancreas
• the middle part, known as the body
• the narrow end, called the tail.

A tube called the pancreatic duct connects the pancreas to the first part of the small bowel (duodenum). Another tube, called the common bile duct, joins with the pancreatic duct and connects the liver and gall bladder to the duodenum. The common bile duct carries bile, a substance that helps the body to digest fats.

The pancreas acts as two glands in one – it functions as a gland to help with digestion (exocrine), and as a gland to control the amount of sugar in the blood (endocrine).

Exocrine function – Groups of exocrine cells (acini) produce juices called enzymes that help break down food. The juices flow through the pancreatic duct from the pancreas into the duodenum. Most of the pancreas is made up of exocrine tissue.

Endocrine function – Scattered among the exocrine tissue are small groups of endocrine cells called pancreatic islets (or islets of Langerhans). These release hormones that control the level of sugar in the blood – the hormone insulin decreases this level, while the hormone glucagon increases it.

The pancreas